摘要
本文报告了2020年1例纵隔脓肿患者的诊治过程,患者中年男性,发热伴有咽痛、颈痛、胸痛起病,门诊心电图如同急性冠脉综合征特点,前壁导联ST段抬高,检验心肌酶谱和肌钙蛋白阴性,门诊冠脉造影未见异常,颈部、胸部CT提示鼻咽、口咽、喉咽、中后纵隔脓肿伴有积气,给予颈部脓肿切开引流和胸腔镜纵隔脓肿切开引流手术,引流脓液行细菌培养提示米勒氏链球菌群,敏感抗生素治疗后患者痊愈出院。本文通过回顾病例的诊治过程,分析颈深部感染合并纵隔脓肿的临床特点,探讨临床诊断思维和治疗方法。
This paper reports the diagnosis and treatment of a case of mediastinal abscess in 2020.The patient was a middle-aged male with fever accompanied by pharyngeal pain,neck pain and chest pain.The ECG of the outpatient department was similar to that of acute coronary syndrome.The ST segment elevation of the anterior wall lead,the test of myocardial enzyme spectrum and troponin were negative.The coronary angiography showed no abnormality.The neck and chest CT showed nasopharynx,oropharynx,laryngopharynx The middle and posterior mediastinal abscess was accompanied with pneumatosis.The neck abscess incision and drainage and thoracoscopic mediastinal abscess incision and drainage were performed.The bacterial culture showed that the Millerian Streptococcus group was detected.The patient recovered after sensitive antibiotic treatment.In this paper,we reviewed the diagnosis and treatment process of the case,analyzed the clinical characteristics of deep neck infection combined with mediastinal abscess,and discussed the clinical diagnosis thinking and treatment methods.
作者
卢开林
邢凡凡
李丽
戴贵剑
王媛媛
何玲
戴鱼雷
张丽
Lu Kailin;Xing Fanfan;Li Li;Dai GuiJian;Wang Yuanyuan;He Ling;Dai Yulei;Zhang Li(Accident and Emergency Department,The University of Hong Kong-Shenzhen Hospital,Shenzhen,China;Department of Clinical Microbiology and Infection Control,The University of Hong Kong-Shenzhen Hospital,Shenzhen,China;Department of ECG diagnosis,Tangshan maternal and child health care hospital,Tangshan,China)
关键词
纵隔脓肿
米勒氏链球菌
急性冠脉综合征
胸痛
Mediastinal abscess
Streptococcus milleri
Acute coronary syndrome
Chest pain
